a medical librarian's adventures in evidence-based living

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May 13, 2009

"Is there a formula--some mix of love, work, and psychological adaptation--for a good life? For 72 years, researchers at Harvard have been examining this question, following 268 men who entered college in the late 1930s through war, career, marriage and divorce, parenthood and grandparenthood, and old age."

If teasing out the secrets of a good life--learning from the mistakes of others--trying to understand how we are shaped & changed by everything we encounter--our parents, our siblings, our circumstances & choices--is something that piques your interest--then go directly to this month's landmark article by Joshua Wolf Shenk, in the June 2009 Atlantic, "What Makes Us Happy?" I loved it!

But before you read it--first read David Brooks' short op-ed in the May 12, 2009 New York Times, "They Had It Made".

Here's the short story: 268 of Harvard's best were selected from the classes of 1942, '43 and '44 to participate in a landmark longitudinal study originally sponsored by the dime store magnate W.T. Grant. These men have been measured, examined & interviewed by physicians, social workers, and psychiatrists their entire lives--all in "an attempt to analyze the forces that have produced normal young men."

Normal, being described as "That combination of sentiments and physiological factors which in toto is commonly interpreted as successful living."

But, hang on to your hats! This is no simple story that lends itself to a list of simple do's & don'ts for prescriptive living. "It turned out that the (men's) lives were too big, too weird, too full of subtleties and contradictions to fit any easy conception of "successful living".

And the best & brightest in the study--Harvard's finest--the likes of which included Ben Bradlee & John F. Kennedy--well, I wouldn't say they had stress-free lives. "Hidden amid the shimmering successes were darker hues."

By age 50, almost a third met Dr. George Vaillant's (the lead investigator for the last 42 years) criteria for mental illness. Alcoholism, depression, divorce, disease, disappointment were experienced by many.

But Vaillant even looks at mental illness through a different lens--having seen these men through til the end of their lives. "Much of what is labeled mental illness, simply reflect our 'unwise' deployment of defense mechanisims. If we use defenses well, we are deemed mentally healthy, conscientious, funny, creative, and altruistic. If we use them badly, the psychiatrist diagnoses us ill, our neighbors label us unpleasant, and society brands us immoral."

The Lessons To Be Learned From Following Lives Until The End

Here's the good news. There are definitely markers for a happy life--which without fail always includes challenges and joys. Here's what caught my attention.

1. Meet Challenges with Healthy Adaptations. Everyone has difficulties. But we don't all use the same adaptations or methods to help make life tolerable. Some of us use unhealthy, immature, & neurotic behaviors--destined to make problems worse--think alcohol, drugs, aggression, withdrawal.

"The healthiest adaptations include altruism, humor, anticipation (looking ahead and planning for future discomfort), suppression (a conscious decision to postpone attention to an impulse or conflict, to be addressed in good time), and sublimation (finding outlets for feelings, like putting aggression into sport, or lust into courtship)."

2. Emotional crises, pain & deprivation are "analogous" to the involuntary grace by which an oyster, coping with an irritating grain of sand, creates a pearl. Humans, too, when confronted with irritants, engage in unconscious but often creative behavior."

6. Depression was the greatest drain on physical health. Of the men who were diagnosed with depression by age 50, more than 70% had died or were chronically ill by 63.

7. "Pessimists seemed to suffer physically in comparison with optimists--perhaps because they're less likely to connect with others or care for themselves."

8. Serving in military combat exacts a huge toll. 80% of the men served in WWII. Those who survived the heaviest fighting developed more chronic physical illness & died sooner than those who saw little or no combat.

9. It's easy to predict who is going to become a Democrat or a Republican from early personality traits. Results from the initial psychiatric interview were consistent: Democrats = sensitive, cultural, & introspective. Republicans = pragmatic and organized.

10. Relationships Rule! "It is social aptitude, not intellectual brilliance or parental social class, that lead to successful aging." Warm connections are necessary--and it doesn't have to be from mom or dad--it can be with siblings, uncles, friends, or mentors.

11. Relationships at age 47 predicted late-life adjustment better than any other variable, except defenses.

12. Good sibling relationships. Getting along with your brothers & sisters is especially powerful: 93% of the men who were thriving at age 65 had been close to a brother or sister when younger.

13. What's the most important lesson that Vaillant (the lead investigator) has learned from the study? "That the only thing that really matters in life are your relationships to other people."

14. Gratitude and joy, over time, will yield better health and deeper connections--but in the short-term, they do put us at risk, because they expose us to rejection & heartbreak.

15. Cholesterol levels at age 50 have nothing to do with health in old age. "If you follow lives long enough, the risk factors for healthy life adjustment change. There is an age to watch your cholesterol and an age to ignore it." Not at all sure what to make of this one?

Dr. Vaillant's Insights from the Study

1. Happiness isn't about me. 2. The most famous of the Harvard men had something to prove to themselves, their families, or the world. People who had everything--those for whom things went well--had less "to prove". They didn't feel a need to become a famous artist or business tycoon.3. Aging is a lot less scary than people think it is.4. Dirty Laundry. Enjoy exactly where you are now--whatever your age or circumstances. It's OK to be young--and it's OK to be old. And, if you're so lucky, enjoy the piles of dirty laundry gathering on the floor from the kids and grandkids and company when they come to visit & bring their messes!5. Age 25-35 is the toughest for virtually everyone. It's scary stuff--what will I amount to? But all you need is to give it time--things will work out! It's not about keeping up with the Joneses or how much money you're making.6. Getting old is as good as being young. The whole process is fun. It's just as much fun to get wrinkles & to reminisce.7.Happiness is about playing and working and loving. And loving is the most important of them all. Happiness is love. Full stop.